Provider Demographics
NPI:1376269787
Name:PRINDLE, ANGELICA S (LPC)
Entity Type:Individual
Prefix:
First Name:ANGELICA
Middle Name:S
Last Name:PRINDLE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 LATTERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-4905
Mailing Address - Country:US
Mailing Address - Phone:512-658-3370
Mailing Address - Fax:
Practice Address - Street 1:715 LATTERIDGE DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-4905
Practice Address - Country:US
Practice Address - Phone:512-658-3370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76861101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional